The URL can be used to link to this page

Home My Public Portal About6274 GOLDEN WEST AVE_Electrical__ _ T � WORKERS'COMPENSATION DECLARATION CE$08G (2-60) APPLICATION FOR ELECTRICAL PERMIT I hereby ffflrm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY insure, or ■ certlflca te of Workers'-Compensation Insurance,or a certlfied'copy thereof(Sec. 3800,Lab.C.) FOR APPLICANT TO FILL IN JOB a Policy No. Company- ADDRESS b New Resldentlel Bldgs.&Pools EACH Np. FEE ❑ Certified copy is.heraby furnished. 1 &2-Famlly,Sq. Ft. $ $ LOCALITYNEAREST .� ❑ Certified copy Is ed with the county butldlnQ Inspection Multi-family Sq. Ft. fil Residential Swimming Pools CROSS 8T department. OWNER OR I'ii I h1 NfR�RC Date Applicant Outlets: Rec.&_Light SW. MAIL Irrt 20 ADDRE CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY–Ve�� Tel No. COMPENSATION INSURANCE PLAN CHECK (This section need not be cmpplet�ed If the work brvolred � APPLICANT by the, pelt is for one hundred don= (=100) or len.) Lighting Fixtures FIrat 20 ADDRESS 'rote[No.�` Additional O I certify that in the.performano of the work for which this, CITY Tal No. 0 permit is Issued, I ahill not employ any person in any manner Fixed Appliances Nat Over 1 HP PERMIT LU so as to become subject to the Worker^Compensation Laws. Range_Heeter_D.W. _ PL NT +' I`4'6' Oven _ Dryer_W.M. LADIDRESS Date Applicant�iNtstt ��(,� Top _ FAU _W.H.f ' Hood — Fran _Other— TY Tel No. NOTICE TO APPLICANT: If, after miking this Certificate of Map. _ Room Air CondomLICENSE Ezemptlon, you should 'become lubject to the Workers' REG.NUMBER Clans Compensation provisions of the Labor Code, you mutt forth- Power Appenctus& Ler�e.Appllances. DISTRICT NO,provisions BY with comply with such provons or this permtt shall be deemed revoked Size&Type HP,KW, KVA,or KVA Up to 1 Incl. FINAL LICENSED CONTRACTORS DECLARATION Over 1 to 10 Incl. DATE �O VALIDATION Over 10 to 60 IncL I hereby affirm that I am llcenaed under provisions of Chapter Over 50 to 100 Inc., FINAL 9 (commencln8 with Section 7000) of Dtvfalon 3 of the Buri- Over,100 BY • nets and Profesilohs.Code, and my license Is In full force and effect. Q 1 Services License Number_ Lfc.ClassQ2DO Amp. Under 600 V 201-1000 Amp.Under 600 V Contractor A Date Over 1000 Amp.or Over 800 V . HOME OWNER-BUILDER DECLARATION Temp.PowerPole&Appurtenances I hereby affirm that I am exefnpt from the Contractor's Sign with One Branch Circuit2 0+�1 3 A License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Clrcults nen and Professions Code): ❑ I, as owner of the o M4c.Conduits&Conductors pir perty, will do the work and the Other(See Complete Fee Schedule)— 12 0 0 structure is not intended or offered for.sale ($action o,o o 2 0 TZy 7044, Business and Proferdons Code). CONSTRUCTION LENDING AGENCY 111.2 Q_8 } I hereby affirm that them Is a construction lending agency for the performance of the work for which this perrnit is PERMIT FEE (Sub-Total) issued (Sec. 3097,Civ.C.). Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) 'Lenders Address PERMIT ISSUING FEE I certify that I have read this application and state that the TOTAL FEE ■bo Informs correct.I armee to comply with all County o nces an Sts laws re"ting Electrical wiring, and herr y au ho re ntatfres of this)County to enter upon the ned p inspection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE ture of Permittee Date WORKERS' COMPENSATION c6Ito o corse �0019D y� APPLICATION FOR ELECTRICAL PERMIT O I"hereby affirm that I have a certificate of consent to self �z Iruuro, qc�r a ceifficate of Workeri Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Or a c o fled copy thereof (Sec. 3800, Lab. C.) Ilcy 160. Company rOR APPUUM TO RL 114 ADDRESS W�� ILJI Certified copy Is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. FEE ❑Certified copy II filed with the county bullding Inspec- 1 8 2-Famlly, Sq. Ft. ; _ $ LOG41fll NEAREST ilon department. Multi-family Sq. Ft. CROSS Resldentlal Swimming Pools VAIIX NER Date Applicant NAS" _ CERTIFICATE OF EXEMPTION FROM WORKERS' LCOMPENSATION INSURANCE Outlets: RecLlght L Sw.�O �//�� ..�� First 20(This section read not be completed H the work Involved by Total No.�Sa_ Additional Yry Tel. No.the permit 4s for ore hundred dollars ($1 DD)or lass.) N U�ECK I certify that In the performance of the work for which this UCANf permit Is lasued, I shall not employ any Person In any mann Ughting Fixtures ( 2 First 20 ADDRESS to as to become subject to the Workers Compensation Additional Date 1.1—PI—F7—Applicant Total No.�'� CITY Tel. No. Fixed Appliances Not Over 1 HP pptMt7 NOTICE TO APPLICANT: If, after ma ng this Certifl APPL}CpTFON Exemption, you should become subject to the Workers' Range— Heater D.W. Compensation provisions of the Labor Code, you must forth- Oven — Dryer �W.M. ADDRESS with comply with such provisions or this permit shall be Top FAU W.H. — deemed revoked. Hood IE Fan Other— CIN Tel. No. LICENSED CONTRACTORS DECLARATION �I UCff SE OR I hereby affirm that I am licensed under provisions of Chapter 9 Dlap. Room Alr Cord. — REG NUMBER 6(commencing with with Section 7000)of Division 3 of the Buslneu Power Apparatus 8 Large Appliances DI ./'l Y and Professions Code,and my license Is In full force and effect. 13- l(�[ Size 8 Type HP, KW, KVA, or KVAR O License Number Llc. Class Up to 1 Incl. FINALU a: Over Over 1 to 10 Incl. DATE VAIJDAMN O I. Contractore Over 10 to 50 Incl. F1 NAL F] 0 I am exempt under Sec. Over 50 to 100 Inc. BY U W B.BP.C. for this reason Over 100 'Cik1d co Date: Ices, Swbd., MCC 8 Panelboards , / z Z 0-200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600V ❑ Exemption for Reg. Malnt. Elect. Over 1000 Amp. or Over 600 V SINGLE FA ILLY DECLARATION Temp. Power Pole 8 Appurtenances l 2 HOME CNJN Branch Circuits l SI Sign with One Branch ClrcultT•T I hereby affirm that I am exempt from the Contractor's Llcense i Sign Law for the following reason (Section 7031.5, Business and Additional g M7 82.50 Professions Code): ❑ I, as owner of the property, will do the work and the Misc. Conduits 8 Conductor 1 ITM structure Is not Intended or offered for sale(Section 704", Other (See Complete Fee Schedule)_ , TOTAL 82 - 50 Busineu and Profenlons Code). CONSTRUCTION LENDING AGENCY �L I hereby affirm that there Is a construgtion lending agency for } the performance of the work for which this permit Ls Issued PERMIT FEE (Sub-Total) (Sec. 3097, Ov. C_). Lenders Name PLAN CHECKING FEE 010IM-M 11/14/8 Lenders Address MI PERT ISSUING Fa I 6766 1 AM 9:29 1 certify that I have read this application and state that the TOTAL FEE above Irrformatlon Is correct. I ogree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize representatives of this County to enter upon thea a mentioned or rty r Inspection pu SEE REVERSE FOR EXPLANATORY LANGUAGE �a SI of r flee Dia to COUNTY OF LOS ANGELES TEMPLE CITY 0 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC %K)RICS 9071 LAS TLK&S EL 0508 9806020022 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT; LEGAL ID: FEES PAID BUILDING ADDRESS: ON FILE 6274 GOLDEN WEST AV FEE DESCRIPTION: QUANTITY: LION: AMOUNT: TEMP CA 917801701 ASSESSOR I ER: NEAREST CROSS STREET: LONGDEN 5385-022-027 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY G1 OUTLETS-LGT,SW,RECP 1.00 OUT 1.95 HA FAU LESS 3HP 1.00 FAU 10.80 . JB AC UNITS +3-10HP 1.00 AC 19.65 06/02/96 UT 06/ TOTAL FEES 60.15 OWNER: TEL. NO: FIkAL DATE FINAL CODE: HUI FAI JOHNNY 6274 GOLDEN WEST AV TEMP 917801701 DESCRIPTION OF WIOR-K ELECTRICAL -FOR HEATING AND AIR CtD. SYSTEM DAVID WEI:DA TAM (626) 308-1938- 122 S. ELECTRIC AVE. SPECIAL CONDITIONS: ALHAMBRA CONTRACTOR: TEL. !� PN(,ELES CO APPROVALS DATE --MPECTOR SIGNATURF-- DAVID WEI DA TAN (626) 308-1938- 122 S. ELECTRIC AVENUE LIC. NO TEMIORARY POWER POLE ALHAMBRA, CA 91801 729019 ARCHITECT OR ENGINEER: TEL. -WD: UFER GROUND LIC. N0: 1 allllll `'1 ROW WIRIWG PLASTIC Y/N METAL Y/N IurrErTy i 1 7 .'r< REPORT ID: DPR265 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY 0508 ELE&RICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS EE 0508 9808310049 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY G PHONE: (818) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: ON FILE 4274'GOLDEN WEST AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP GA 917801701 NEAREST CROSS STREET: 5385-022-027 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY F1 120V 15/20A BR C1CTS 1.00 BR 17-25 G1 OUTLkTS-LGTSW RECD 12.00 OUT 23.40 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES . G2 LIGHTING FIiiaES 3.00 LGT 5.85 08/31:/98UT 08/31/99 TOTAL FEES 74.25 HUI FAI JOHNNY - 6274 GOLDEN WEST AV TEMP 917801701 L)hSGKiPllUN OF WORK f ELtuuc k_FOR NEW ADDITION ..- APPLICANT: TEL. NO: LUMINA DESIGN i CONSTRUCTION, INC. (626) 574-9969- 5634 HALIFAX R.D. SPECLkL CONDITIONS: ARCADIA, G 05 Pqa EL 5 co �T ` -CONTRACTOR. TEL. NO: DATE INSPECTOR SIGNATURE LUMINA DESIGN & CONSTRUCTION (626) 574-9969- 5634 HALIAX RD. LIC. NO TEMPORARY POWER POLE ARCADIA, G 7518M ARCH I TEr_T-OR--ENGI NEER: TEL. NO: UFER GROUND LIC. N0jWATER LINE 111111 D p � D W O�K S PLASTIC Y/N METAL Y/N MAIN UTILITY COMPANY NOT � � t O D � w Service Ths REPORT ID: DPR265 ROUTE TO: BS0508 I COUNTY OF LOS ANGELES TEMPLE CITY 0508 ELFgTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TAUS EL 050$ 0301310001 BUILDING AND SAFETY / LAND DEVELOPMENT . TEMPLE CITY CA 91780 PHONE: (626) M-0488 EXT: LFGAI ID: FEES PAfl5__ BUILDING ON FILE 6274 GOLDEN WEST:AV FEE DESCRIPTION: QUANTITY: LION: AMOUNT: TEMP CA 417801701 ASSESSOR NEAREST CROSS STREET: LONGDEN 5385-022-027 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY G1 OUTLETS-LGT,SW RECD 3,00 OUT 5.85 TENANT: G2 L(GHTIMG'FIXTLAES 1.00 LGT 1.95 ON. - TOTAL FEES 35.55 01/31/03 JK 07/30/03 OWNER: TEL. NO- FINAL DATE - FINAL BY: CODE: HUI FAI JOHNNY - 6274 GOLDEN WEST AV TEMP 917801701 DEMTM Lm ut- WORK� LIGHT, SWITCH ; OUTLET FOR PATIO APPLICANT: JEL. NO: CROCKERR {714) 268-1314- 706 N TUSTIN AVE SPECIAL CONDITIONS: ORANGE 92867 P�yGELES Co APPROVALS DATE INSPECTOR SIGNA E ALL PRO REMODELING (714) 288-1314- SOS ��Ty 706 N TUSTIN AVENUE LIC. NOTEMPORARY POWER POLE ORANGE, CA 92867 574696 B UNDERGROUND CNOIT ARCHITECT OR ENGINEER: TEL. NO: UFER GROUND LIC. N0. ROUGH CONDUIT ROUGH WIRING 111111 MAT"TER LINE L , f7 II C CME PLASTIC.Y/N METAL (/N UTILITY COMPANY WTI FIED \A fi O��/ 3 rvice That REPORT ID: DPR265 ROUTE TO: BS0508